CINCINNATI — Terry Flick recognized Lindenwald Medical Center for what is was the moment she walked in: "A place to get pills." As a recovering drug user, she knew better than most what a waiting room packed with doctor-shoppers looked like — and Lindenwald's was "a room full of addicts," she testified Thursday in U.S. District Court.
Flick took the stand as part of a procession of witnesses who testified that one of Lindenwald's physicians, Dr. Saad Sakkal, had prescribed their family and friends addictive medications in dangerous amounts. Many spoke through tears about their loved ones’ overdoses, some from prescription drugs such as oxycodone and Xanax, others from a combination of pills that Sakkal had prescribed and street drugs such as heroin.
Sakkal was indicted as part of the largest national healthcare fraud and opioid takedown in American history — a sting that caught 76 doctors, 23 pharmacists, 19 nurses and other medical personnel across the nation in June 2018.
He stands accused of overprescribing pain pills and deadly drug combinations that directly led to at least two patients’ deaths. He also faces 30 counts of illegal distribution of controlled substances and seven counts of using a nurse practitioner’s prescription pad to write prescriptions for his patients.
Flick testified about her friend, Penny, who died of an overdose in June 2016 just weeks after she took her to Sakkal’s office for prescriptions.
Fidgety, agitated patients paced across the waiting room that day; the office had become so full an overflow crowd gathered outside. Penny friend received five prescriptions from Sakkal, including methadone, Vicodin and Adderall, which caused her to slur her speech and nod off to sleep, Flick said.
Sandra Prewitt, a former medical assistant at Lindenwald, estimated 75-80% of patients were there for pain medication. Two patients passed out in the waiting room, and many others were visibly high.
“I felt that was the only reason they were there,” said Prewitt, who noted that Sakkal saw 50 to 60 patients each day.
Sakkal continued to prescribe pain pills to patients who tested positive for street drugs in urine screens or who had prior overdoses, she added. Prewitt used the Ohio Automated Rx Reporting System (OARRS), to monitor patients’ controlled substance prescription history until Sakkal told her to stop it because “it took too much time.”
When Sakkal left the practice in late 2016, the doctors who replaced him refused to prescribe as much pain medicine. Many old patients “quit coming,” Prewitt said.
Sakkal stands charged with directly causing the overdose deaths of two patients: Ashley Adkins, 31, of Middletown, and 51-year-old Lisa Anne Hawkey of Hamilton. Each charge carries a mandatory minimum penalty of 20 years to life in prison.
Marilyn Fields testified about the slew of medications that her mother, Lisa Anne Hawkey, received from Sakkal five days before she died of an overdose on Feb. 14, 2016 – including Valium, Percocet and four other medications.
“She had an enormous amount of Prozac in her system,” Sakkal’s attorney, Richard Goldberg, pointed out during cross-examination, noting that it had been prescribed by a doctor other than Sakkal.
Hawkey had six to seven times the therapeutic dosage of Prozac in her system when she died, Goldberg said.
“This patient took way more of them than she should have taken?” Goldberg asked Dr. James Swinehart, a Butler County deputy coroner.
“Yes,” Swinehart admitted.
Goldberg told the jury in his opening statement that both Adkins and Hawkey had committed suicide. Although Sakkal gave them the medication, Golberg argued he could not be held responsible for for their decision to use more than medically recommended — particularly if they had, as he claimed, explicitly wanted to end their own lives.
However, Swinehart said both deaths were caused by accidental overdoses. He said Hawkey had been treated at a hospital emergency room for prior overdoses.
The trial will continue into next week.